RAFAEL EUGENIO COPLIN REYNOSO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

ACTIVE

Business

Title

First Name

RAFAEL

Middle

EUGENIO

Last Name

COPLIN REYNOSO

Business Name

RAFAEL EUGENIO COPLIN REYNOSO MD

Original Issue Date

01/13/2021

Effective Date

07/22/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/22/2023